Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.
Nigeria Centre for Disease Control, Abuja, Nigeria.
PLoS One. 2018 Jun 19;13(6):e0199257. doi: 10.1371/journal.pone.0199257. eCollection 2018.
Nigeria reports high rates of mortality linked with recurring meningococcal meningitis outbreaks within the African meningitis belt. Few studies have thoroughly described the response to these outbreaks to provide strong and actionable public health messages. We describe how time delays affected the response to the 2016/2017 meningococcal meningitis outbreak in Nigeria.
Using data from Nigeria Centre for Disease Control (NCDC), National Primary Health Care Development Agency (NPHCDA), World Health Organisation (WHO), and situation reports of rapid response teams, we calculated attack and death rates of reported suspected meningococcal meningitis cases per week in Zamfara, Sokoto and Yobe states respectively, between epidemiological week 49 in 2016 and epidemiological week 25 in 2017. We identified when alert and epidemic thresholds were crossed and determined when the outbreak was detected and notified in each state. We examined response activities to the outbreak.
There were 12,535 suspected meningococcal meningitis cases and 877 deaths (CFR: 7.0%) in the three states. It took an average time of three weeks before the outbreaks were detected and notified to NCDC. Four weeks after receiving notification, an integrated response coordinating centre was set up by NCDC and requests for vaccines were sent to International Coordinating Group (ICG) on vaccine provision. While it took ICG one week to approve the requests, it took an average of two weeks for approximately 41% of requested vaccines to arrive. On the average, it took nine weeks from the date the epidemic threshold was crossed to commencement of reactive vaccination in the three states.
There were delays in detection and notification of the outbreak, in coordinating response activities, in requesting for vaccines and their arrival from ICG, and in initiating reactive vaccination. Reducing these delays in future outbreaks could help decrease the morbidity and mortality linked with meningococcal meningitis outbreaks.
尼日利亚报告称，在非洲脑膜炎带，反复发生的脑膜炎球菌脑膜炎疫情导致死亡率居高不下。很少有研究全面描述对这些疫情的应对情况，从而提供强有力和可操作的公共卫生信息。我们描述了时间延迟如何影响尼日利亚 2016/2017 年脑膜炎球菌脑膜炎疫情的应对。
利用尼日利亚疾病控制中心（NCDC）、国家初级卫生保健发展署（NPHCDA）、世界卫生组织（WHO）的数据以及快速反应小组的情况报告，我们计算了 2016 年第 49 周至 2017 年第 25 周期间，在赞法拉、索科托和约贝州每周报告的疑似脑膜炎球菌脑膜炎病例的发病率和死亡率。我们确定了警戒和流行阈值何时被越过，并确定了在每个州何时发现和通报疫情。我们检查了对疫情的应对活动。
在这三个州，有 12535 例疑似脑膜炎球菌脑膜炎病例和 877 例死亡（病死率：7.0%）。疫情被发现并通报给 NCDC 需要平均三周时间。接到通报后四周，NCDC 成立了一个综合反应协调中心，并向疫苗供应国际协调小组（ICG）请求疫苗。ICG 虽然用了一周时间才批准请求，但大约 41%的请求疫苗平均需要两周时间才能到达。从流行阈值被越过到三个州开始进行反应性疫苗接种，平均需要九周时间。
在发现和通报疫情、协调应对活动、向 ICG 请求疫苗及其抵达、以及启动反应性疫苗接种方面，存在延迟。在未来的疫情中减少这些延迟，可以帮助降低与脑膜炎球菌脑膜炎疫情相关的发病率和死亡率。
